Term
| Risk factors for dysfunctional labor |
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Definition
- obesity
- decreased physical fitness
- short height
- older age >35
- fetal weight >4kg
- paternal height/maternal head to height ratio
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Term
| How does Friedman define prolonged latent phase |
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Definition
>20 hrs nullips
>14 hours multips |
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Term
| Outpatient meds for sedation for prolonged latent phase |
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Definition
- hydroxyzine (vistaril): 50-100 mg PO or IM
- Dyphenhydramine (Benadryl): 50 mg PO
- Zolpidem (Ambien): 5-10 mg PO
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Term
| Inpatient meds for sedation |
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Definition
- morpine sulfate: 15 mg IM (20 mg for larger women)
- re-evaluate after 20 mins, if UC's have ceased or decreased resp. no more doses are given
- if pt cont to have UC's with no cx change, 10 more mg can be given
- IM onset is 10-20 mins, lasts 2.5-4 hrs
- on average gies women 6-10 hrs rest
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Term
| Friedman's definition of active phase protraction disorders |
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Definition
| <1.2 cm/hr for nullips and <1.5 cm/hr for multips |
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Term
| Zhang's defintion of active phase |
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Definition
| begins at 6 cm regardless of parity |
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Term
| Friedman's definition of active phase arrest |
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Definition
| no dilation once in the active phase (>4 cm) for 2 or more hours |
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Term
| ACOG definition of active phase arrest |
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Definition
| no cervical change for at least 2 hours after latent phase completed and a contraction pattern exceeding 200 Montevideo units |
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Term
| ACOG prolonged second stage definition |
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Definition
nullips: 2 hrs w/o epidural
3 hrs w/epidural
multips: 1 hr w/o epidural
2 hrs w/epidural |
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Term
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Definition
- possible increase in UC's
- cord prolapse
- cord compression
- FHR decels
- increased infection
- bleeding from fetal or placental vessels
- discomfort of procedure
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Term
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Definition
- bulging membrane serves to pre-stretch perinewum before crowning
- pressure from intact membranes helps with ripening and effacement and dilation
- pressure stimulates oxytocin surges in much the same way as presenting fetal part
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